Article

Plasma lipids and lipoproteins and the incidence of cardiovascular disease in very elderly. The Bronx Aging Study

Department of Medicine, Albert Einstein College of Medicine, Bronx, N.Y.
Arteriosclerosis and thrombosis: a journal of vascular biology / American Heart Association 05/1992; 12(4):416-23. DOI: 10.1161/01.ATV.12.4.416
Source: PubMed

ABSTRACT The Bronx Aging Study is a 10-year prospective investigation of very elderly volunteers (mean age at study entry, 79 years; range, 75-85 years) designed to assess risk factors for dementia and coronary and cerebrovascular (stroke) diseases. Entry criteria included the absence of terminal illness and dementia. All subjects (n = 350) included in this report had at least two lipid and lipoprotein determinations. Overall, more than one third of subjects showed at least a 10% change in lipid and lipoprotein levels between the initial and final measurements. Moreover, mean levels for women were consistently different than those for men, and because of this finding subjects were classified into potential-risk categories based on the changes observed by using their sex-specific lipid and lipoprotein distributions. The incidences of cardiovascular disease, dementia, and death were compared between risk groups. Proportional-hazards analysis showed that in men a consistently low high density lipoprotein cholesterol level (less than or equal to 30 mg/dl) was independently associated with the development of myocardial infarction (p = 0.006), cardiovascular disease (p = 0.002), or death (p = 0.002). For women, however, a consistently elevated low density lipoprotein cholesterol level (greater than or equal to 171 mg/dl) was associated with myocardial infarction (p = 0.032). Thus, low high density lipoprotein cholesterol remains a powerful predictor of coronary heart disease risk for men even into old age, while elevated low density lipoprotein cholesterol continues to play a role in the development of myocardial infarction in women. The findings suggest that an unfavorable lipoprotein profile increases the risk of cardiovascular morbidity and mortality even at advanced ages for both men and women.

0 Followers
 · 
81 Views
 · 
4 Downloads
  • Source
    • "Juan Domingo Perón 4190 2nd floor (C1181ACH) Buenos Aires, Argentina; Tel: 054 11 4958 4454; Fax: 054 11 4958 4454; E-mail: claudia.alonzo@hospitalitaliano.org.ar and cohort studies have found that risk related to plasma lipid levels is lower in the elderly [4] [5] while others have found no such difference. However, there still may be sex differences in this risk [6] [7] [8]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: As population grows old, the number of persons at risk of cardiovascular events also grows. Though octogenarians form a small percentage of the general population their absolute risk of coronary and cerebrovascular disease is high, but there is still some doubt as to whether high plasma cholesterol levels increase vascular risk in this age group, as published data are conflicting. There is evidence that elevated plasma cholesterol increases the risk of coronary artery disease in older adults, and an inverse linear relationship was found between HDL cholesterol levels and the risk of mortality from ischemic heart disease in all age groups. The relationship between total plasma cholesterol and the risk of death from ischemic stroke is weak in younger populations and is even lower in people between 70 and 89 years, and is inverse for hemorrhagic stroke. However, studies showed that statin treatment lowers the risk of ischemic stroke, independently of age. Statins are underused in the elderly, perhaps because of lack of perception of the real vascular risk of older adults, concerns about statin efficacy or safety in this population, or the increase of comorbidities and polypharmacy which could affect adherence to drug-treatment. Trials designed to address this issues are urgently needed, in order to be able to make evidence-guided decisions on lipid management of the elderly.
    03/2011; 11(1):17-23. DOI:10.2174/187152911795945141
  • Source
    • "Another study reported a statistically significant association between lower total cholesterol levels and higher rates of cognitive decline in older populations, but its clinical significance remains unclear.57,58 In an Italian study of elderly people, those who converted from MCI to AD tended to have higher serum HDL levels and lower serum folate levels.42 "
    [Show abstract] [Hide abstract]
    ABSTRACT: We estimated the prevalence of Alzheimer's dementia (AD) and mild cognitive impairment (MCI) and their risk factors in an urban community setting, focusing especially on metabolic syndrome. A two-phase investigation based on a door-to-door survey was performed. In Phase I, we administered the Korean version of the Mini-Mental State Examination (MMSE-KC) of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K). Assessment Packet and the Korean version of the Geriatric Depression Scales (GDS-K) to all 706 participants aged 65 years or older. In Phase II of the study, 175 persons underwent physical and neurological examinations according to the protocol of the CERAD-K clinical assessment battery [CERAD-K (C)] and the neuropsychological assessment battery [CERAD-K (N)]. We also examined the association between cognitive decline and metabolic syndrome. AD and MCI were defined using the DSM-IV-TR criteria and the Clinical Dementia Rating (CDR) scales. The mean age (+/-SD) of the subjects was 74.3+/-16.7 years and the ratio of males to females was 53.2 to 46.8. The prevalence of Alzheimer's dementia was 9.0%, while that of MCI was 32.9%. Old age and lower educational level had significant associations with cognitive decline in the elderly, but gender, years of alcohol intake or smoking, and metabolic syndrome were not associated with AD or MCI. In this study, metabolic syndrome was not associated with Alzheimer's AD or MCI. Information regarding an association between Alzheimer's dementia and metabolic syndrome in this study will be helpful in formulating future public health policy and prevention strategies in Korea.
    Psychiatry investigation 06/2008; 5(2):78-85. DOI:10.4306/pi.2008.5.2.78 · 1.15 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Statin therapy (3-hydroxy-3methylglutaryl coenzyme A reductase inhibitor) is beneficial for primary prevention of cardiovascular events in patients younger than age 65 years with hyperlipidemia, yet there is uncertainty about using these agents for primary prevention in octogenarians. We present the case that can be made for not treating octogenarians with statins for the primary prevention of cardiovascular disease. This case is built on three points: 1) cholesterol levels are not associated with cardiovascular disease events in octogenarians without overt coronary artery disease; 2) no randomized, controlled trials have assessed the role of statins in reducing events in octogenarians without coronary artery disease; and 3) statins may increase risks of myositis, rhabdomyolysis, and cancer in the elderly. In view of gaps in the current evidence and the resulting clinical uncertainty, it is unclear whether the balance of risk and benefit favors treatment for the primary prevention of coronary artery disease in octogenarians. The use of statins in this age group should be based on patient preference.
    The American Journal of Geriatric Cardiology 12(6):357-60. · 0.86 Impact Factor
Show more

Preview

Download
4 Downloads
Available from